Extracellular-vesicle-based cell-to-cell communication is conserved across all kingdoms of life. There is compelling evidence that extracellular vesicles are involved in major (patho)physiological processes, including cellular homoeostasis, infection propagation, cancer development and cardiovascular diseases. Various studies suggest that extracellular vesicles have several advantages over conventional synthetic carriers, opening new frontiers for modern drug delivery. Despite extensive research, clinical translation of extracellular-vesicle-based therapies remains challenging. Here, we discuss the uniqueness of extracellular vesicles along with critical design and development steps required to utilize their full potential as drug carriers, including loading methods, in-depth characterization and large-scale manufacturing. We compare the prospects of extracellular vesicles with those of the well established liposomes and provide guidelines to direct the process of developing vesicle-based drug delivery systems.

基于细胞外囊泡的细胞间通讯在所有生命王国中都是保守的。有令人信服的证据表明，细胞外囊泡参与主要（病理）生理过程，包括细胞稳态、感染传播、癌症发展和心血管疾病。各种研究表明，与传统的合成载体相比，细胞外囊泡具有多个优势，为现代药物输送开辟了新的前沿。尽管进行了广泛的研究，但基于细胞外囊泡的疗法的临床转化仍然具有挑战性。在这里，我们讨论了细胞外囊泡的独特性以及利用其作为药物载体的全部潜力所需的关键设计和开发步骤，包括装载方法、深入表征和大规模制造。